She described how “most clinicians” would have made the same mistake given the unprecedented circumstances.

But she denied suggestions that heightened awareness of the virus had “made practitioners fit the symptoms to the diagnosis”.

Miss Perfect told the inquest in Norwich: “Swine flu was at the forefront of everybody’s mind. Had that not been a factor I would have been looking at other reasons.

“At the time we were being advised not to take people with swine flu to hospital and not to take them to a doctor’s surgery.

“Anybody with swine flu was to stay at home because we did not want the virus to be spread to other people.”

A statement on behalf of the East of England Ambulance Service was read at the start of the inquest.

It said: “The ambulance trust does recognise there have been shortcomings in this case and has apologised to the family.”

Action has been taken to prevent future tragedies, it added.

Georgia Keeling died after being rushed to hospital on August 4, 2009, at the height of the swine flu pandemic.

Her older sister, Charlie, had earlier been correctly diagnosed with the disease, contributing to the confusion.

After her death, her parents, Paul Sewell and Natasha Keeling, of West Earlham, spoke out to highlight a catalogue of failings.

Giving evidence, Ms Keeling said a paramedic had arrived earlier in the day only to send an ambulance away because it was “another case of swine flu”.

“They gave me some Tamiflu and I was told all I had to do was get her temperature down,” she added. “I felt relieved because I thought she had been diagnosed and had all the stuff she needed.”

Georgia’s condition continued to deteriorate throughout the day.

Breaking down in tears, Ms Keeling said: “I went to the toilet and she screamed out ‘mum’ to me. She sounded really distressed. Her eyes were glazed over and she wasn’t breathing. I was trying to resuscitate her.”

Ms Keeling called 999 immediately and an ambulance arrived at about 4pm. Georgia was taken to the Norfolk and Norwich University Hospital but was pronounced dead at 4.24pm.

A post-mortem later showed she died from septicaemia - the blood poisoning form of meningitis.

Ms Keeling said: “She was a fantastic girl. She had a great character, even when she was naughty. You couldn’t tell her off because she always made you laugh.”

Mr Sewell said he rang NHS Direct and carried out the “glass test” on the rash to see if Georgia was suffering from meningitis.

The rash seemed to disappear, although the outline remained visible.

He told the inquest: “They said it was probably a virus which was going around. I felt reassured it wasn’t life-threatening so I went to work.”

Georgia had seemed healthy and happy until two days before her death, Ms Keeling said.

But on August 3 she suddenly developed a high temperature, was “off her food” and was restless when she went to bed.

Describing the day of her death, Ms Keeling added: “She woke up at about 6am and asked for a cup of tea like she normally did.

“I noticed a rash on her legs. It looked like bruises all over her legs.

“She was still very hot, she was quiet. She was normally quite a noisy little girl.”

Ms Keeling said she initially suspected it was chicken pox but her mother suggested she contact a doctor.

The city’s West Earlham surgery told her no appointments were available for two days.

Ms Keeling was told to contact the swine flu hotline, which had been introduced during the pandemic. If given the all-clear, she would be seen at another surgery.

Hotline staff told her that the presence of the rash meant it was unlikely to be swine flu.

She decided to dial 999 and the first ambulance, which was turned away, arrived at about midday.

Paramedic Patricia Perfect said she visited the family’s home and made the swine flu diagnosis after a 45-minute examination.

She ruled out meningitis because the rash disappeared when pressed.

“I went on the history of vomiting, the fact she was having pains and she also had a high temperature,” she added.

“Swine flu was at pandemic proportions and most clinicians at that time, if presented with those symptoms, would have come up with the same diagnosis.